Understanding the Lived Experience of Cognitive Remediation in Schizophrenia: A Qualitative Comparison With an Active Control

Objective: Cognitive remediation (CR) is a promising method of improving cognitive functioning in people with schizophrenia. Nevertheless, the lived experience of participation, and whether this differs from computer game (CG) playing control conditions, remains poorly understood. This study aimed to qualitatively compare the experience of participating in these 2 interventions. Method: Forty-two outpatients with schizophrenia or schizoaffective disorder completed a qualitative survey with 7 open-ended questions after completing 10 weeks of CR (n = 22) or CG (n = 20). An iterative and inductive thematic analysis was used to identify and tally reoccurring codes and facilitate their organization into overarching themes. Results: Four high-order themes summarized the data: (a) Perceived benefits; (b) Experience of group; (c) Operation of group; and (d) Suggestions for improvement. Participation was described as enjoyable with similar levels of social and intrinsic benefits reported by study completers in both CR and CG groups. CR completers were more likely to report improvements in memory and everyday functioning as well as greater opportunities to acquire new cognitive skills and experience personal and cognitive challenge. CR completers also described the pursuit of shared goals with other peers. Conclusions and Implications for Practice: CR and CG share qualitative benefits in schizophrenia. CR may, however, offer a supportive environment where participants can encounter and surmount personal challenges, learn new abilities that may be functionally relevant and experience team-based success. These benefits may be unique to CR and contribute to increases in self-efficacy, which could bridge the gap between capacity and real world functioning in schizophrenia.